Provide claim processing services for members, doctors, and clients as provided by the company's various plans and programs. Positions are assigned either to an In-Network Claims unit that handles claims for doctors or an Out-of-Network Claims unit that reimburses patients when they go to a different provider.

Effectively and efficiently process claims ranging from routine to complex situations

Evaluate claim data to pay correct claim benefit amounts according to the company's plans and programs. This requires in-depth knowledge of the following areas:

• Plans, products and services
• Processing transactions
• Policies and procedures for claim payment
• Accurate completion of the necessary documentation, letters, and forms processing

Effectively maintain and support quality, productivity, and timeliness standards

Contact members or doctors, as well as receive and respond to telephone calls as needed

Gathering information, processing claims and written correspondence

Job Specifications

Typically has the following skills or abilities:

One to two years experience in a medical office, medical insurance provider, or related technical education with exposure to CPT, HCPC, and ICD-9 codes

General understanding of how medical claims forms and codes are used

Demonstrated ability to work independently with minimal supervision

Takes initiative to effectively carry out responsibilities

Familiarity with the terminology and nature of work performed in a medical claims unit

Skill to use multiple automated information systems to retrieve and verify data

Proficient in a Windows environment with word processing, spreadsheet application, and data entry

Effective written and verbal communication skills including the ability to develop and respond clearly and accurately to inquiries

#LI-HYBRID

#LI-VISIONCARE

Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here .

Salary Ranges: $15.00 - $21.50

Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information.

We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities.

As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees. VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies.